My Crystalens HD Results

[peakhope]

Before my surgery, I promised myself I would post my results to this forum, whether they were terrible or perfect. When I was trying to choose a lens, I appreciated every first-hand report, so I'll share my story in the hopes of helping others.

Short version: Male, 40's, Florida, myopia (-4) with astigmatism (-4) in each eye, no cataracts or other problems. Got Crystalens HD with LRI's in both eyes. Both were targeted at -0.25, and were done one week apart. After six weeks, distance vision is 20/25 and improving, intermediate vision is outstanding, and I can read J1 (or better).

Long version:

The procedures: First/right eye was uneventful. Left eye had an issue with the pressure during closing, so required stitches. No pain during either procedure, and during the first I never even saw a hand, blade, or anything else. My corneal astigmatism was about -2, with-the-rule.

Initial vision: In the post-op recovery room, I was able to see the clock on the wall about 20 feet away. So I knew right away that I wasn't blind. Within a day, each eye was able to see my computer screen (a laptop at about 24"). Intermediate vision to about 8 feet came in over the next several days, and distance vision became good enough for me to feel safe driving after about a week.

Six weeks later:

My near vision is outstanding, even though I haven't done any exercises. In good light, I can easily read all the tiny print on the back of a credit card. With no real effort, I can focus to about 16". At times, I can focus as close as about 12". At computer distances (2-3'), my vision is nearly perfect. I switched to a smaller font on my computer. At TV distance (8') things are not yet perfectly clear, but I think that is partly due to the stitches that have not yet been removed from my left eye.  I have no trouble watching TV.

My distance vision has been slow to come in, which was a surprised based on my research. In a relaxed state, everything is a bit blurry...probably something like 20/40. But I can pull my eye muscles a certain way, and draw it into focus. So far, I can do it pretty easily for one eye at a time. I'm still practicing doing it for both eyes at the same time. I suspect my right eye would be 20/15 or at worst 20/20 by itself. My left eye is probably more like 20/30 or 20/40 now, but should improve. For now, it still has the stitches, may still have a little astigmatism (not sure yet), and has a week less of recovery time behind it.

My vision is better sometimes than at other times. Not hugely, but sometimes I can't read distant text that I was able to read the previous day. I assume it is a combination of dryness (I am still using over-the-counter moisturizing drops at times), tiredness, subtle lighting changes, and just the fact that my brain is still learning how to use these new dynamic lenses.

I have noticed a few issues with glare, but they have been minor. Light shining in from above or the side can make it harder to see clearly. At certain angles, I see little golden sparkles. but moving my eye a bit makes them go away. Night driving is probably a bit better than it was with my eyeglasses, with slightly smaller halos and starbursts.

My (unplanned) stitches were the least pleasant part of the whole experience. They were slightly painful at times a couple days post-op, and a few times a day they still just feel uncomfortable. As if I have a contact lens in my eye (which I never liked). The LRI's were a bit uncomfortable at times for a couple days, but healed more quickly than I expected.

I have used reading glasses once or twice in the last week, mostly due to poor lighting. I'm not sure I would say I "needed" them, but I'll probably keep a pair around the house. Plus a magnifying glass, for when I want to get really close to something. Other than that, I hope to be glasses-free for the rest of my life. Yay!

Overall, so far, I am extremely happy with the outcome. I am definitely happy that I went with the HD's instead of any other IOL's that are available today. I know not everyone has a great outcome with these lenses, but when you do, it is unbeatable.

Final thoughts: Don't settle for the older Crystalens Five-0 (non-HD) model. Choose a doctor that you have a lot of confidence in. Unexpected things may come up, so you want someone you trust. Don't expect the Crystalens to work perfectly right away...allow at least 3-4 weeks, and realize that your vision may continue to improve for weeks or months after that. Understand that things can go wrong; this is not yet a perfect science. Even with a "good" outcome, your vision might not be as good as you had hoped, you might need reading glasses, or distance glasses. Do your research, get all your questions answered, make your choice, and hope for the best.

[John C Hagan III, MD, FACS]

Thanks for your posting. I agree entirely with your recommendations.

1. Be sure you're willing to wear glasses some times.
2. Be prepared for some glare/flare and night problems.
3. Pick a highly skilled CONSIDERATE AND COMMUNICATIVE surgeon that does refractive surgery (Lasik/LRI).
4. Avoid the REZOOM
5. Get the Crystalens HD (not the 5.0)  second choice new ReStor Aspheric +3.00 or +4.00 for reading eye.

JCH MD

[peakhope]

Follow-up ten months after surgery. I'm not as happy as I was, although I don't regret having the implants. They were still a better choice for me than Restor or monofocal lenses.

My doctor hadn't done any refractions as part of my standard follow-up exams. I would strongly urge anyone else to insist that they do them. I finally did. My right eye is -1.25 with -.50 astigmatism, and my left is +0.25 with -2.50 astigmatism. That explains why my distance vision, while technically about 20/30, remains quite blurry, and why I have had excellent near vision. I was able to pass my drivers license eye exam (20/40) barely, after being given a  second guess on one line, which prompted me to insist on the refraction.

I bought a pair of (distance-only) glasses to help decide what if any further surgery to get, and with them I have 20/15 or better vision. I have some dimness/smearing in my right eye which will require a YAG procedure. With glasses, my left eye can focus as close as about 2 feet (might improve with practice), and my right eye would probably be the same, but the smearing makes it tough to read.

I think my doctor overshot my astigmatism on the left eye, in which case I wouldn't be able to correct the remaining astigmatism with further LRI's. So I'm facing lasik/prk in that eye. After that, I would have mini-monovision (right eye at 1.50 with very minimal astigmatism) so I would probably just live with that rather than having yet another surgery.

I was really hoping to avoid lasik/prk, but it looks like I'll either have to get one, or live with "ok" vision, or with glasses.

If I had the whole thing to do over again, I still would get Crystalens HD's, but would have pushed for a refraction after 3-4 months. That way, at least I would have known my status and options sooner, and wouldn't have gone so long with vision that was preventing my eyes from doing the practice necessary to get the most long-term benefit from my Crystalens HD's.

[John C Hagan III, MD, FACS]

thanks for letting us hear your story

JCHMD

[lostvision]

Yoy sat donot get the HD 500???? Is that right? WHY???

[lostvision]

Sorry      SAY and do not


Can't see to type with my HD 500's, or read, or drive, or work, or walk, pretty much anything.

[John C Hagan III, MD, FACS]

I favor monofocal aspheric IOLs for myself and any one that asks my opinion. Multifocal are too expensive, too many complications, too many optical abberations (dysphotopsia) and poor night vision and glasses often still necessary

JCH MD

[peakhope]

One more update, 4 weeks after lasik: My lasik went well, so my left eye now has at least very good vision from about 2-3 feet out to infinity.

My negative dysphotopsia is gone, so I assume it was being caused by me squeezing my eyeball (using my eye muscles, not my fingers) enough to offset some of the 2.5 diopters of astigmatism that I had. That was that "pulling" I had described earlier. I don't have to "pull" any more, which is great. I suspect the residual astigmatism was largely due to my needing stitches in that eye.

Before I had any surgery, while doing research, I had considered monovision, but wasn't sure I could adapt to it (and couldn't try it ahead of time because I can't wear contacts). If I had done it, I would have wanted my left eye set for distance, despite 2 eye docs saying my right eye was dominant and therefore should be the distance eye.

In the end, I decided to go for plano in both eyes, but by accident, I ended up with monovision, left eye for distance. All in all, I'm probably happier with this than I would have been with both eyes plano, because it works great for my computer work which is at about 2 feet, plus my right eye works well to within about 1 foot, and it is nice to be able to see close without reading glasses.

I am back to being very happy with my outcome.

[peakhope]

I forgot to mention my yag. I had it in my right eye, and it worked well. I have occasional small floaters, but they go away within minutes. My vision was clearer and sharper right away.

I was surprised at how intense the yag procedure was. Each zap of the laser felt like someone was tapping their finger hard on the inside of the back of my skull. The tech said they had done hundreds of them, and I was only the second person to report that. It wasn't painful, but it was surprising and uncomfortable.

My advice remains: Don't rush into a yag. Make sure you really need one (get a second or third opinion if necessary). Don't get one if you think you might end up wanting to replace your lens with a different one. But if you really do need one, and you are otherwise happy with your new lens, go ahead and get it.

[JodieJ]

I'm glad to learn that you're happy with your outcome.  All's well that ends well.  Please clarify one point:  Did you say that your YAG was performed by a tech???

[peakhope]

No, the doc did the yag. The "tech" was probably a nurse, actually. One of two other people in the room during the procedure. Sorry for the confusion.